Assessment at antiretroviral clinics during TB treatment reduces loss to follow-up among HIV-infected patients.
<h4>Setting</h4>A South African township clinic where loss to follow-up during TB treatment may prevent HIV-infected TB patients from receiving life-saving ART.<h4>Objective</h4>To determine factors associated with loss to follow-up during TB treatment.<h4>Design</h4...
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| Auteurs principaux: | , , , , , |
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| Format: | article |
| Langue: | EN |
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Public Library of Science (PLoS)
2012
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| Accès en ligne: | https://doaj.org/article/ea4b51aead9548ee9d72613a10d26df5 |
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| Résumé: | <h4>Setting</h4>A South African township clinic where loss to follow-up during TB treatment may prevent HIV-infected TB patients from receiving life-saving ART.<h4>Objective</h4>To determine factors associated with loss to follow-up during TB treatment.<h4>Design</h4>Regression analyses of a cohort of ART-eligible TB patients who commenced TB treatment and were followed for 24 weeks.<h4>Results</h4>Of 111 ART-eligible TB patients, 15 (14%) died in the ensuing 24 weeks. Of the remaining 96 TB patients, 11 (11%) were lost to follow-up. All TB patients lost to follow-up did not initiate ART. Of 85 TB patients in follow-up, 62 (73%) initiated ART 56 days after TB diagnosis (median, IQR 33-77 days) and 31 days after initial assessment at an ART clinic (median, IQR: 18-55 days). The median duration from TB diagnosis to initial assessment at an ART clinic was 19 days (IQR: 7-48 days). At 24 weeks, 6 of 85 (7%) TB patients who presented to an ART clinic for assessment were lost to follow-up, compared to 5 of 11 (45%) TB patients who did not present to an ART clinic for assessment. Logistic regression analysis (adjusted odds ratio = 0.1, 95% confidence interval [95% CI]: 0.03-0.66) and our Cox proportional hazards model (hazard ratio = 0.2, 95% CI: 0.04-0.68) confirmed that assessment at an ART clinic during TB treatment reduced loss to follow-up.<h4>Conclusion</h4>Assessment at antiretroviral clinics for HIV care by trained health-care providers reduces loss to follow-up among HIV-infected patients with TB. |
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